Research article
Physical Activity in Men and Women with Arthritis: National Health Interview Survey, 2002

https://doi.org/10.1016/j.amepre.2005.12.005Get rights and content

Background

Regular physical activity in persons with arthritis has been shown to decrease pain, improve function, and delay disability. This study estimates the national prevalence of leisure-time physical activity and identifies factors associated with physical inactivity in adults with arthritis.

Methods

Data from the 2002 National Health Interview Survey were analyzed in 2004–2005 to estimate the proportion of adults with arthritis meeting four physical activity recommendations put forward in Healthy People 2010 and one arthritis-specific recommendation established by a national expert panel in arthritis and physical activity. Multivariate logistic regression was used to evaluate the association between inactivity and sociodemographic factors, body mass index, functional limitations, social limitations, need for special equipment, frequent anxiety/depression, affected joint location, joint pain, physical activity counseling, and access to a fitness facility.

Results

Adults with arthritis were significantly less likely than adults without arthritis to engage in recommended levels of moderate or vigorous physical activity, and 37% of adults with arthritis were inactive. In both men and women with arthritis, inactivity was associated with older age, lower education, and having functional limitations; having access to a fitness facility was inversely associated with inactivity. Among women, inactivity was also associated with being Hispanic, non-Hispanic black, having frequent anxiety/depression or social limitations, needing special equipment, and not receiving physical activity counseling. Among men, inactivity was also associated with severe joint pain.

Conclusions

Although physical activity is a recommended therapy for people with arthritis, levels among adults with arthritis are insufficient, and those with arthritis have worse activity profiles than their peers without arthritis. Efforts to promote physical activity should include expanding access to evidence-based interventions and recreational facilities/programs. The importance of physical activity counseling and associated pain management measures by healthcare providers should be emphasized.

Introduction

Arthritis, the leading cause of disability in the United States,1 affected 43 million U.S. adults in 2002.2 This imposes an enormous economic burden, with total costs attributable to arthritis in 1997 estimated at $86 billion.3 Among those with arthritis, physical inactivity can contribute to deconditioning, impaired function, poor mental health, and an increased risk of obesity. A recent 2-year longitudinal study found that older adults with arthritis who did not engage in regular vigorous activity were twice as likely to experience functional decline as those who did.4 In addition, inactive adults have higher medical costs than those who are regularly active.5

Both strength training6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22 and aerobic exercise16, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31 have been shown to benefit people with osteoarthritis and rheumatoid arthritis, significantly decreasing pain while delaying disability and improving gait and function; other physical and psychological benefits have been reported in patients with fibromyalgia32 and systemic lupus erythematosus.33 Although studies have generally found that low-to-moderate–intensity physical activity does not worsen arthritis symptoms or disease activity,6, 23, 24, 26, 34, 35 increasing physical activity in this population has been challenging, in part because of continued misconceptions about the potential harm to joints and concerns about increased pain.36, 37

Physical activity is one of the major non-pharmacologic interventions for managing arthritis,38, 39 and physical activity is a focus area in Healthy People 2010 (HP2010).40 The purpose of this study is to conduct a secondary data analysis of a national data set to: (1) determine the national prevalence of various levels of leisure-time physical activity in adults with and without arthritis that are consistent with recommendations in HP2010 and recommendations of a 2002 national panel of experts in arthritis and physical activity,41 and (2) identify sociodemographic and other factors associated with physical inactivity in adults with arthritis to better identify those who might be at greater need for intervention.

Section snippets

Data Sources

Data from the 2002 National Health Interview Survey (NHIS) were analyzed in 2004–2005. The NHIS is an ongoing, national household interview survey designed to represent the U.S. civilian, non-institutionalized population and uses a multistage, complex sampling design.42 The response rate for the sample adult component (18 years and older) in 2002 was 74.3% (n=31,044).43

Definition of Arthritis

Doctor-diagnosed arthritis (n=6829), hereafter called arthritis, was defined by a “yes” response to “Have you ever been told by

Results

Compared to adults without arthritis, adults with arthritis were more likely to be older, female, non-Hispanic white, less educated, obese, have frequent anxiety/depression, have one or more functional or social limitations, need special equipment, have one or more comorbid conditions, and not be meeting HP2010 physical activity recommendations or the recommendation of an expert panel on arthritis41 (Table 1).

After age adjustment, the percentages of adults with and without arthritis who were

Discussion

These findings are the first report of physical activity levels among adults with and without arthritis using a national data source and a validated arthritis case definition. Despite substantial evidence showing that physical activity benefits people with arthritis, adults with arthritis are significantly less likely than adults without arthritis to be meeting HP2010 recommendations for moderate or vigorous physical activity, and overall physical activity levels in adults with arthritis remain

References (70)

  • J. Bolen et al.

    Racial/ethnic differences in the prevalence and impact of doctor-diagnosed arthritis—United States, 2002

    MMWR Morb Mortal Wkly Rep

    (2005)
  • E. Yelin et al.

    Medical care expenditures and earnings losses of persons with arthritis and other rheumatic conditions in the United States in 1997total and incremental estimates

    Arthritis Rheum

    (2004)
  • D.D. Dunlop

    Risk factors for functional decline in older adults with arthritis

    Arthritis Rheum

    (2005)
  • G. Wang et al.

    Inactivity-associated medical costs among U.S. adults with arthritis

    Arthritis Rheum

    (2001)
  • G.R. Komatireddy et al.

    Efficacy of low load resistive muscle training in patients with rheumatoid arthritis functional class II and III

    J Rheumatol

    (1997)
  • K.S. Thomas et al.

    Home-based exercise programme for knee pain and knee osteoarthritisrandomised controlled trial

    BMJ

    (2002)
  • K.R. Baker et al.

    The efficacy of home based progressive strength training in older adults with knee osteoarthritisa randomized controlled trial

    J Rheumatol

    (2001)
  • M. Fransen et al.

    Physical therapy is effective for patients with osteoarthritis of the kneea randomized controlled clinical trial

    J Rheumatol

    (2001)
  • S.C. O’Reilly et al.

    Effectiveness of home exercise on pain and disability from osteoarthritis of the kneea randomised controlled trial

    Ann Rheum Dis

    (1999)
  • R.J. Petrella et al.

    Home based exercise therapy for older patients with knee osteoarthritisa randomized clinical trial

    J Rheumatol

    (2000)
  • A. Hakkinen et al.

    A randomized two-year study of the effects of dynamic strength training on muscle strength, disease activity, functional capacity, and bone mineral density in early rheumatoid arthritis

    Arthritis Rheum

    (2001)
  • W.H. Ettinger et al.

    A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST)

    JAMA

    (1997)
  • J.M. Schilke et al.

    Effects of muscle-strength training on the functional status of patients with osteoarthritis of the knee joint

    Nurs Res

    (1996)
  • L.C. Rall et al.

    The effect of progressive resistance training in rheumatoid arthritis. Increased strength without changes in energy balance or body composition

    Arthritis Rheum

    (1996)
  • F.B. Wyatt et al.

    The effects of aquatic and traditional exercise programs on persons with knee osteoarthritis

    J Strength Cond Res

    (2001)
  • M. Hopman-Rock et al.

    The effects of a health educational and exercise program for older adults with osteoarthritis for the hip or knee

    J Rheumatol

    (2000)
  • M.E. van Baar et al.

    Effectiveness of exercise therapy in patients with osteoarthritis of the hip or kneea systematic review of randomized clinical trials

    Arthritis Rheum

    (1999)
  • B.W. Penninx et al.

    Physical exercise and the prevention of disability in activities of daily living in older persons with osteoarthritis

    Arch Intern Med

    (2001)
  • S.P. Messier et al.

    Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritisthe Arthritis, Diet, and Activity Promotion Trial

    Arthritis Rheum

    (2004)
  • G.B. Neuberger et al.

    Effects of exercise on fatigue, aerobic fitness, and disease activity measures in persons with rheumatoid arthritis

    Res Nurs Health

    (1997)
  • C. Ekdahl et al.

    Dynamic versus static training in patients with rheumatoid arthritis

    Scand J Rheumatol

    (1990)
  • C.H. van den Ende et al.

    Comparison of high and low intensity training in well controlled rheumatoid arthritis. Results of a randomised clinical trial

    Ann Rheum Dis

    (1996)
  • C.H. van den Ende et al.

    Effect of intensive exercise on patients with active rheumatoid arthritisa randomised clinical trial

    Ann Rheum Dis

    (2000)
  • M.A. Minor et al.

    Efficacy of physical conditioning exercise in patients with rheumatoid arthritis and osteoarthritis

    Arthritis Rheum

    (1989)
  • P.A. Kovar et al.

    Supervised fitness walking in patients with osteoarthritis of the knee

    Ann Intern Med

    (1992)
  • Cited by (194)

    • Physical activity and osteoarthritis

      2021, Revue du Rhumatisme Monographies
    View all citing articles on Scopus
    View full text